Provider Demographics
NPI:1013787597
Name:TAUBER ORTHODONTICS LLC
Entity Type:Organization
Organization Name:TAUBER ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KORRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-715-3944
Mailing Address - Street 1:6930 RAMBLING VALE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-6602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12455 BROADWELL RD STE 100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6377
Practice Address - Country:US
Practice Address - Phone:770-526-0190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty